Report/Complaint to the Committee on Discipline

Background Information

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Your full name:

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Please note: Anonymous reports limit the ability of OSCCS/COD to respond (see instructions above).

Your position/title:

Your phone number:

Your email address:

Email address must be of a valid format.

Your physical address:

Nature of this report(Required):

This field is required.

Urgency of this report(Required):

This field is required.

Date of incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

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Specific location:

Involved Parties

Please list the individuals involved (excluding yourself), including as many of the listed fields as you can provide.

Name or Organization

Select Role

MIT ID Number if known

DOB (YYYY-MM-DD) if known

Phone number

Email address

Questions

As completely as possible, describe the events surrounding the incident, ideally in chronological order. This field is required.

I understand that, in the course of investigation or resolving this reported matter, the Office of Student Conduct and Community Standards provides documents to complainants/reporting parties, respondents, advisors, administrators, and panel members. I understand that, as my name appears in this document, it may be seen by these parties for their roles in this matter and I consent to my name being shared in this manner. I understand that if I have questions about this, I can contact the Office of Student Conduct and Community Standards at osccs@mit.edu or 617-258-8423. Further, I understand that the Institute has the following expectations for honesty and integrity: “Fundamental to the principle of Independent learning and professional growth is the requirement of honesty and integrity in conduct of one’s academic and nonacademic life.” By typing my initials below and submitting this form, I confirm that, to the best of my knowledge, this document adheres to those expectations of honesty and integrity fundamental to the Institute.(Required)

Yes

You must make at least one selection.

Supporting Documentation

Please upload any relevant documentation to your submission. This can include photos, screen shots, e-mails, papers, etc. ***If this is an academic integrity case, please upload relevant materials, including course syllabus and alleged materials.*** 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Background Information

Involved Parties

Questions

Supporting Documentation

Submission